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Prescription Drugs

presdrugs

Prescriptions medications are covered when: 

 

  • They are ordered by your provider or another doctor treating you or your child and the drug is listed on the Texas Medicaid Formulary.
    • The Texas Medicaid Formulary is the list of approved drugs that doctors can order for you.
  • They are ordered or given while you are in an emergency room or hospital.
  • They are given while you are in a rest home, nursing home or convalescent hospital.
  • They are ordered by a plan doctor for a covered service. You got them through a pharmacy that is in the Molina Pharmacy Network.

 

If you cannot leave home, Molina can provide you with mail order pharmacy. This is done by CVS Caremark Mail Services. Some of the pharmacies also have delivery service. Please call Molina Member Services Toll Free at (866) 449-6849. We will tell you how to get mail delivery.

Generic medications
Generic drugs have the same ingredients as brand name drugs. To be FDA (government) approved, the generic drug must have the same active ingredient, strength and dosage (formulation) as the brand name drug.

Member Handbook
It tells you what you need to know about your STAR Program. You may get value-added services in your area. Read here

How do members get care?
Call Member Services at (866) 449-6849, Monday to Friday, 8:00 a.m. - 5:00 p.m. if:  

  • You need to ask about a drug
  • You have trouble getting a prescription filled at the pharmacy (Please do not pay for the prescription)
    • Prescriptions are covered through Molina Healthcare’s contracted pharmacies within Texas. Prescriptions are covered outside of the state of Texas (out of area) for emergency or urgent services only
  • You need an interpreter to communicate with the pharmacy about getting your medication
  • When you have an emergency and need drugs, Molina Healthcare will provide you with up to a 72-hour supply of the drug

 

If you are deaf or hard of hearing:
For English call our TTY line at (800) 735-2989 or 711
For Spanish call (800) 662-4954

To view a list of pharmacies, please click here.
To view the Texas Medicaid Formulary, please click here.